血、尿RBP水平判断原发性肾病综合征肾脏损伤程度和预后的价值

Value of using serum and urinary RBP levels to determine the kidney injury degree and prognosis of patients with primary nephrotic syndrome

目的检测原发性肾病综合征(PNS)患者血清、尿视黄醇结合蛋白(RBP)水平,探讨其对患者肾脏损伤程度和预后判断的价值。方法收集50例PNS患者,行肾穿刺病理检查,根据小管间质损伤(TID)程度将患者分为两组,A组TID≤2分、B组TID>2分。另设正常对照组,检测三组的血清、尿RBP,24 h尿蛋白总量及肾功能。对PNS患者给予强的松及相应的降压抗凝等治疗,2个月后复查血清、尿RBP,肌酐及尿常规。根据疗效分为激素敏感(尿蛋白转阴)、激素部分敏感(尿蛋白+^++)、激素不敏感(尿蛋白>+++)三组。比较三组的血清、尿RBP变化及与激素敏感性的相关性。结果与正常对照组相比,A、B两组血清、尿RBP,血肌酐、尿素氮均升高(P均<0.05),B组较A组变化更显著(P均<0.05)。与激素敏感组相比,部分敏感组和不敏感组治疗前血清、尿RBP均有升高,部分敏感组较不敏感组变化更显著(P均<0.05)。Spearman相关分析显示,治疗前血清RBP、尿RBP与激素敏感性呈正相关(P均<0.05)。结论血、尿RBP可以反映PNS患者的肾小管间质病变的严重程度,并且可以作为判断预后的指标。

Objective To determine the kidney injury degree and prognosis of patients with primary nephrotic syn -drome （PNS） by observing the changes of serum retinol-binding protein （RBP） and urinary RBP.Methods Fifty pa-tients with PNS underwent the pathological examination of renal puncture .According to the tubular and interstitial lesion score （TID）, all patients were divided into two groups： group A TID≤2 and group B TID 〉2, additionally, the normal control group was set .The serum RBP , 24 h total urinary protein and renal function were detected in the three groups . Compare the differences between the three groups .The PNS patients were treated with prednisone and the corresponding blood anticoagulation , the serum RBP , creatinine and urine routine were reviewed after two months .According to the effect, they were divided into three groups：hormone sensitive group（urine protein negative）, part hormone sensitive group （ urine protein ＋~＋＋） and non-sensitive group （ urine protein 〉＋＋＋） .The correlations of serum RBP and urina-ry RBP changes with hormone sensitive were compared among the three groups .Results Compared with the normal control group, blood and urine RBP , serum creatinine and urea nitrogen were increased in the group A and B , group B had more significant changes than group A .Compared with the hormone sensitive group , blood RBP and urine RBP were increased in the part hormone sensitive group and non-sensitive group , and the part hormone sensitive group had more significant chan-ges.Spearman correlation analysis showed serum RBP and urinary RBP before treatment was positively correlated with hor -mone sensitivity .Conclusion The serum and urinary RBP can reflect the severity of renal tubule lesions in PNS patients and can also be used as the indicator in determining the prognosis .